At a young age, Sal Volpe, M. D., became enam- ored of a well-known—but fictitious—family physician. “I grew up with Marcus Welby,” Vol- pe recalls. The late Robert Young played the TV character who was the kind of physician every- one dreams about: patient, concerned, with aseemingly endless supply of time for each patient and possessing aremarkable blend of medical knowledge and avuncular wisdom.Decades later, the grown-up Volpe—who’s certified in pediat-rics, geriatrics and internal medicine—is attempting to recreatethat type of doctor-patient relationship in his own solo practice inStaten Island, N. Y.

There are a couple of key differences. Volpe documents his carewith an electronic health record, having abandoned the papercharts ubiquitous during the Welby era. And unlike Welby, whopracticed in an era all but devoid of pre-authorizations, high de-ductibles and insurance plan second-guessing, Volpe must con-tend with the economic realities of modern medicine. That’s whyhe has fashioned his practice around the “patient-centered medi-cal home” model of care delivery. The model—in place at a grow-ing number of primary care practices—attempts to temper thevolume-based mania of fee-for-service medicine with a preventiveapproach designed to be more meaningful—and effective—for pa-tients and physicians alike. The model can also reduce care costs,which is why growing numbers of payers are incentivizing it.